H: I asked Dr. Gary if she would be willing to converse with me about the local work
with homeless families and individuals. I particularly wanted her to focus on the
physical, psychological, and mental health needs of homeless people. Then,
since the plight of the homeless has far-reaching socioeconomic implications, I
wanted her also to share her views about these broader areas. Faye Gary,
E.D.D., fellow of the American Academy of Nursing, is a professor in the College
of Nursing, University of Florida. She is internationally recognized for her work in
psychiatric mental health nursing. Among her many mental health activities are
the following: editor of a major textbook in psychiatric and mental health nursing;
consultant to the Ministry of Health, Kingdom of Lesotho, Southern Africa;
consultant, University of the Western Cape, Capetown, South Africa. She also
serves on numerous local, state, national, and international committees that
address health in general and mental health specifically. [Today is Thursday,
April 1, 1993, and] this history is being taped by Betty Hilliard as part of the class
project [Oral History Seminar, University of Florida, Dr. Samuel Proctor,
professor] on the homeless.

Faye, it is so good of you to give us a little bit of time to talk about your career
and your work with the homeless, and to share some of your ideas about the
problems and the realities and what might be done.

G: Thank you, Betty. It is a privilege to be here. I remember you very fondly as a
very supportive and hard-working, knowledgeable colleague. So it is my
privilege. I feel honored that you have asked me to respond to this.

From the local perspective, I would like to focus on my work with the homeless
by sharing with you my observations and knowledge about a special population,
and that is runaway and homeless children. As you know, in mental health my
focus has always been on children and families, recognizing that children are a
part of the family which includes adults. In Ocala I have been for the last two
years president of the board of directors of the shelter for runaway and homeless
children called Arnett House. My experiences at Arnett house have led me to
know that children run away or choose to become "homeless" for many reasons.
One of those reasons is the environment within which they have to live at home.
Children also give these reasons for running away: too much alcohol and
substance abuse among the parents or adults in the home, abuse spouse
abuse and then child abuse, child abuse meaning neglect and physical abuse.
But what children flee from the very most is incest, and that incest occurs with
children, girls and boys, and step-fathers, number one, biological fathers, two,
and grandfathers, three.

H: That is just so surprising.

G: And four is neighbors and male friends of the family. They also feel that
because they seem to have no advocate in their family, the best thing they know
to do is to flee. Now, once a child runs from trouble, he or she runs into trouble,
trouble that they may not have envisioned, because life on the street means
doing hard time. If a child leaves because he or she has been exploited sexually
or physically at home, you can bet that will be magnified at least times ten on the
streets. You find young girls saying they had sex with a man who bought her
hamburger and a milk shake, or a boy who might say the very same thing.

Now our country has responded a bit late but has responded by building
shelters, and these shelters now are part of the HRS [Health and Rehabilitative
Services] conglomerate. Children can go to the shelters they can show up
there themselves, they are taken there by the police, by the sheriff's department,
by HRS, public health nurses, and one time there were kids at this shelter taken
there by forest rangers, because the forest rangers had found children sleeping
in the Ocala National Forest.

Now, the children do not go there as their first choice. They try it out themselves,
because the streets, even though frightening, are also alluring to them. It is
when they get in trouble or become exhausted or feel totally exploited or just
worn out that they seek the shelters, which means that the children who come to
the shelters are extremely damaged, disappointed, distrusting, etc. According to
the national literature, there was a study done out in San Francisco. They had a
study whereby girls could have a pelvic examination, and an overwhelming
percentage of these girls had pelvic inflammatory disease. There is a lot of
discussion and debate about whether the girls and the boys in the shelter should
be automatically tested for the HIV virus or not. On the one hand, that seems
like a noble thing to do, and we could argue that these children would get
services and would get AZT and other prophylactic medications. But the reality
is that this does not occur. The reality is, if these young children are tested and
this information gets on their health records someplace, they run the risk of being
stigmatized. Believe it or not, some facilities would prefer not to admit youth who
are HIV positive.

H: Now, why is that? Is it lack of knowledge or the prejudice?

G: It is lack of knowledge, it is fear about the disease, it is the fact that they can
always argue that their beds are filled anyway, so they do not have to confront
this problem. A lot of people are still in denial about HIV and AIDS, especially as
it comes to children. They think it is a disease that prostitutes and gay people in
the gay community might acquire. But that is not the case. It is a very
democratic disease, a very democratic process.

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H: That is an interesting adjective to use for HIV.

G: Yes. It is extremely democratic. It is totally non-discriminatory. My position at
the moment is that, unless children are counseled and provided medications,
placed in programs designed to encourage behavior change, their HIV status
has little meaning to themselves and others. See, the other part is the children
do not get any medications, and they know this, and sometimes that is extremely
psychologically devastating to them. These are children who have very limited
support systems, who have almost no adult advocates, and have virtually no
resources.

H: What age range are you talking about?

G: We accept children at that shelter from the eleven to seventeen. Now, the
average child in America begins sexual activity at about age thirteen or fourteen.
Some groups are younger, and that tends to be related to socioeconomic status
or is primarily a neighborhood kind of thing. So that is from the local perspective,
and that is specifically what you are asking me to [address].

H: Yes.

G: Also, from a tangential perspective I have had some contact with the Salvation
Army in Ocala. The Salvation Army is an organization that I truly admire,
because they, through the years have recognized homeless people. That was
one of the first organizations to provide a "comprehensive" service,
"comprehensive" meaning food, shelter, some counseling, and some attempt to
provide health care, because in the homeless population I am talking about
children or adults the health problems that you frequently find are back
problems and backaches.

H: Backaches?

G: Backaches, and foot problems.

H: Now, that is interesting.

G: Yes.

H: Do you know why?

G: Well, they have packs on their backs and take heavy loads on their backs, all of
their precious possessions, and they have foot problems because they walk.
Their feet have not been bathed, and they get blisters on their feet, athletes foot,
and all kinds of other foot problems, just because of limited foot care.

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H: I never would have guessed that would have been a primary health problem.

G: Major problem. Major.

H: That would make sense when you share a little bit of that lifestyle.

G: Yes. Exactly.

H: It must be awful.

G: Then the other is skin problems, for the same reason for foot problems -
improper hygiene.

H: Cannot get to a shower.

G: No shower. They get wet, and the clothes dry on their backs. Another problem
is tuberculosis. You see now a lot of concern about tuberculosis among the
homeless, because, as you know, tuberculosis is highly communicable. The
sputum from a homeless person can land anyplace. It can land on a rich person
or a poor person, a person in the ghetto or a person in the nicest suburb. So this
is beginning to be a national health problem.

H: Actually, it is on the rise again.

G: Yes, and of course what happens in our society is that these kinds of highly
communicable diseases show up in that population, among people who have no
resources, first. So if you want to look at what is lurking below the iceberg, look
at the homeless population, and there you are going to find tuberculosis, AIDS,
and other sexually transmitted diseases. It is at an epidemic proportion among
homeless people and among runaway children. AIDS and STDs that is what is
below the iceberg. [These are] highly communicable [diseases]. In a sense I
call them interpersonal diseases, because you get it from another person.

H: That is right.

G: And even though we want to encourage interpersonal relationships, we have to
teach and coach homeless children and youth how to negotiate out of
deleterious or potentially deleterious situations for their own physical safety and
psychological safety. What a child will tell you is when they are on the streets
they are not prostitutes. They call it survival sex. That is the only resource they
have, whether they are male or female, and all of the other people who are
willing to exploit them know that, and they quickly learn that the only resource
they have is to provide sexual pleasure. In our society, just like the rest of the

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world, the younger a girl or boy is the more they are willing to pay for the sexual
encounter because they think that these children are less likely to have AIDS,
and they are less experienced, which means that they will be more likely to
participate in the demands of the payer.

H: Ugly, isn't it.

G: Yes. It is total exploitation of our children. But that is the phenomenon I see all
over the world. Everyone wants their younger [children]. In Japan, in the
Philippines, in Africa, in South America, they want young girls because their
thinking is flawed they think the children, the girls and the boys, are more likely
to be disease-free and would make less demands on the man or the woman,
who is the aggressor in the situation. It is quite disheartening when you look at
the kinds of situations that our young children are forced into. My friends in
Africa tell me that prostitution is directly related to economics.

H: It is.

G: And I agree with them that unless we can address the issue of poverty among
women, we will never eradicate prostitution. And I totally agree. These are
public health issues in South Africa. They are saying that unless women have
the opportunity to go to school and learn and have a viable career, prostitution
will always flourish, especially in developing countries. But I could say the same
thing in America. The men have the jobs in construction, the white-collar jobs,
the blue-collar jobs, etc., and the women can only lure the men to them. They
have one resource the men are interested in, and that is a sexual encounter.

H: I think you can see that right here in our clinics.

G: I think we see the same thing in America. Yes, the same thing. So the thing you
have to look at is how the economic situation forces women to prostitute their
bodies and what really is the consequence. Even though the woman's body is
used and sometimes mutilated, I think the greatest victim is the child that is born
from that, and children are born. The woman has to try to rear that child out of
hostility and sometimes pure hatred, because she really did not want that child.
She was trying to make a living. But the byproduct is the child who is really
never cared for and nurtured and parented.

G: The other fascinating thing is that, in America, where we do have some access
to birth control for children, even though there is a lot of political controversy -
and Betty, you know this better than I do the percentages of pregnancy have
continued to climb in the last ten to fifteen years. Children are becoming
sexually active at a very, very early age. I am repeating myself, but the literature
says age thirteen. That is pretty young. The literature also states that children

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are having sex earlier and are more promiscuous and many times their partners
are anonymous; that is, they do not even know the names of their partners. So
the children are doing sex without knowing the name of their partners. It would
be difficult to convince me that they try to negotiate out of this situation or that
they try to negotiate a situation where the partner would use condoms.
Therefore, I think that runaway children are at highest risk for contracting AIDS
or other STDs, as well as tuberculosis, and mental illness, etc.

H: You wonder how much they know to be able to negotiate when they are so
young.

G: Right.

H: They really do not have the tools to help themselves get out of that terrible mess.

G: That is right. They do not have [the mental capacity yet]. Developmentally, their
cognitive abilities are still in the process of being formalized; they are still at the
concrete point in their thinking, and they have no negotiation skills.

The other is that if you look at children who are down and out and on the line,
how they will live twenty years from now is at least a thousand years away in
their minds. They are interested in tonight. "When can I get these filthy clothes
off? How in the world can I ever brush my teeth?"

H: Very basic things.

G: "I wonder what my mommy is doing." Many of them do become suicidal, and
unfortunately our mental health system has not been able to respond to the
many changes in demands that come from our society. Our mental health
system has not been shored up since the Carter administration, it really has not.
It has been deteriorating now for the last twelve years.

H: Is that not the point in time when so many patients from mental health [hospitals]
were discharged (hopefully) to use community health centers? Is that not the
period in time that happened?

G: That came a bit earlier, but we had community mental health centers that were
calling it the deinstitutionalization process. The deinstitutionalization process
began in the 1970s, but all mental health facilities under the Community Mental
Health Centers Act of 1974 would be required to have twelve basic services,
among which were services for the geriatric population, children and youth,
alcoholism and drug addiction, consultation, school base, evaluation and
research, crisis intervention, community support programs for nurses to go out to
the homes to check on medication, etc. The others I cannot think of off the top

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of my head.

H: How effective do you think those were?

G: I think it was very effective. We would have been many light years ahead had
we continued those services. I say that for several reasons. Number one, we
would have continuously refined that process and by now probably would have
affected it. Number two, 25 to 40 percent of all homeless people have a
psychiatric history.

H: [Nearly] half?

G: Yes. Those people who have been on the streets for quite a while who do not
have psychiatric problems eventually develop them, and we are back to the
stress [syndromes]. If you look at a stress model, that would make sense. You
know, given a certain amount of stress over a period of time, anybody can break.

H: There is not any hope or help when all you have is stress.

G: That is right; that is exactly right. So what they do is drink and do drugs, but
primarily drink.

H: Anything to escape. That is what those are, just escape mechanisms.

G: They primarily drink wine, cheap wine, and eventually they end up with their
livers being destroyed, the pancreas being destroyed. They develop all these
physical health problems and just give up. They just completely give up.

The other is that those people, especially the ones with the previous history of
psychiatric illness, could get some help through the Social Security Supplement
Disability Plan, but they are on the move, and no one knows where they are.
There are considered to be millions, probably billions, of dollars uncollected.

H: That could be used.

G: They could use that if they had an address, yes. Some places will allow
homeless people to use their address. When I was at Georgetown some time
ago one of the things that students did at Georgetown [was], they had to do so
much community service in order to graduate. This is when Father Timothy
Healy was president. I do not know how it is now. Some of the people would
allow the homeless in Washington to use the Georgetown University address.
The students would go to the shelters, where they would serve food on
Saturday, and the checks or whatever mail that had come in the students would
take to the homeless people. That was their linkage with another structure, a

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very reputable structure. I think that could work well almost anyplace. Churches
could do that; public schools could do that. You would have to have it organized.
But I think we have to revisit how we link into humanity in our society.

H: Do we have a mechanism or anything like that in this area?

G: Not that I know of.

H: It would be a very good idea for someone to do, to get involved with.

G: Yes, exactly. I see those kinds of linkages hopefully being established. We
have to have the right kind of philosophy or the right kind of ideal. You have to
buy into that kind of ideal, and I think in our society we see "them and us" or
"them and they" and that kind of thing, and homeless kids are completely
disconnected from their families or disconnected from other youth. But to me I
think we have to find a connectedness again. Anytime we allow children to slip
through the slats by default or design, we are compromising every person in this
nation.

H: We are. That brings me to think of something you said a minute ago about
twenty years ahead, that the children right now are [totally focused on] basic
things that they want right now, but what are they going to be like when they are
adults, having had that terrible experience as children?

G: Some of them have told me they have no idea.

H: Well, they probably do not, but I am just wondering if a mature, healthy adult
capable of nurturing and bringing a family up well needs certain things in
childhood.

G: Exactly.

H: And these children do not have them.

G: Exactly.

H: What does that say about our population in the future?
G: Exactly. I think we are on a slippery slope myself.

H: I do, too.

G: I really think we are on a slippery slope, because as you look at the children, not
only do they tell you they do not know what they want to be, but they will tell you
that do not know if they want to be anything. Some see themselves as being in

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institutions where they will be taken care of. Others tell you they see themselves
in jails. Some say, "Maybe someday somebody will marry me and be nice to
me," but that is a very small percentage who even think that way, and it is an
even lower percentage [for whom] that will ever happen, that somebody will
come and rescue them. But they are looking for rescue. That is fine, because
the person who looks for a rescuer, at least that person, I think, feels that there is
some hope. But to think that a man is going to rescue a women is quite archaic.

I agree that what a family cannot provide for itself, the government should assist.
I think that is what government is all about. There is almost no need to have a
government if the government cannot assist its citizens. I think we are going to
have to revisit that.

H: Do you think Mr. Clinton, or should I say Mrs. Clinton, [will address these
issues]?

G: Well, I like President Clinton.

H: I do too.

G: I think he is a man who knows how to think.

H: Even though he dodged the war and the Republicans [laughter].

G: That is all right.

H: That is what Republicans are like [laughter].

G: But I think we have to have a thinking man as president, and I think he is a
thinking man. I think he is well read, and I think that for the first time in my adult
life I have seen a man who is comfortable with all people. I think he is generally
comfortable with women, I think he is generally comfortable with African
Americans, I think he is generally comfortable with Hispanics, with Jews,
whatever. I have not seen that in my adult life in another person. I think that
they have been placaters and not very comfortable or too closely tied to the old
boys situation and not sure about women. But I think this man is quite
contemporary. And to have a woman like [Attorney General] Janet Reno, who is
taller than he is and can think just as fast as he can, is quite a credit to him.

H: I do too.

G: Yes. So I am hoping we are in for a new era for our country. Whether we are an
independent, democratic, or republican, I think we have to rise above the survival
level. We have to decide whether we are going to be a great nation or not, and

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there are some issues we have to put to rest. The economic divide is one of
them. We have to have opportunities for everybody. I think if you listen to what
the reactors say, that is exactly what they are talking about.

H: It is a tremendous problem. To be frank, when we started I had not given to
much consideration to the terrible childhood problem.

G: Well, see, I had not either. I just thought I would go out and look at homeless
people. I received a Kellogg fellowship and as a part of our application we had
to put together a phenomenon or an area that we would explore that we had
never explored before should we get the scholarship. I wrote up the homeless,
because that was an area I had not explored. But being a psychiatric nurse, I
knew about the plight of people because of deinstitutionalization. Then I began
to look at homeless people, and I found that the greatest victims were children.

H: You stayed with them to cope with them?

G: Exactly, and it seems to me logically that I should have been able to figure that
out because I have worked with children throughout my career, but I had not
made the linkage. When you see children sleeping in the car with the mother,
then you have great empathy for that mother, but you also have to know that
those children have nothing to say about where they are, not even where mama
would park that day, in a sense. So I had to rethink my focus for that. Then
when I looked at how they survived, I had to refocus again and say that these
children probably will not even get to become adults, or when they get to be
adults they will become symptomatic for AIDS.

I just read last night or the night before last that it is considered that the AIDS
[virus] is growing fastest in the population between the ages of eighteen and
twenty-nine, and given a ten-to-twelve year incubation period, I am thinking that
these eighteen to twenty-nine year olds who become symptomatic for AIDS were
infected when they were in their adolescence.

There are some programs. I am on a National Institutes of Health [NIH] Review
Committee we are an AIDS study review committee and I can say that one of
the priorities that is occurring is that there be community-based programs for
AIDS prevention among youth. Now, I serve on that review committee, so that is
primarily what I see. [The work of the committee focuses] not only on youth but
on people in general. But I do know that an alarming number of people are
concerned now about the possibility that we are talking about a group of
American children who are going to be infected. In the next ten years we will not
have the resources to provide health care for them, because, you see, they may
not become symptomatic until years later. Of course that is what [happened] to
Arthur Ashe, [who received the virus from a blood transfusion], and with [Earvin]

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"Magic" Johnson. So we know that people can have the virus and just not show
it.

H: Not for several years.

G: That is right. Exactly. The other thing that makes youth more vulnerable is
because they think they are invulnerable. [According to their way of thinking,]
whereas you and I could get AIDS, there is no way they can get it. That is part of
the growth and development issue in adolescence, that they are just omnipotent.

H: It is going to happen to other people, maybe, but not to me.

G: Never. So the possibility of HIV striking comes when the person is quite
vulnerable in terms of cognitive awareness developmentally. It is the most
vulnerable period. Then you are talking about something that is pleasurable for
them. Also, in many ways it is the in thing to do, which leads me to another
issue, and that is that the advanced thinkers in our society think it is okay for
children to be exposed to such on television, to the violence and the
pornographic or the near-pornographic explicit kinds of sexual encounters that
occur on television.

H: That is right. It has really been within the last fifteen or twenty years that this
kind of freedom has been exhibited on television.

G: Exactly. In most programs, [especially] the detective programs or dramas, a
man and woman end up in bed, and I have never seen a negotiation for condom
use. You know, they still glamorize it. They have these beautiful beds, beautiful
women, and these handsome men in bed. That is what children see.

H: Of course, those will be the role models.

G: Sure. That is what children see. And it seems that there is no regard for the
consequences of that. I think that the advanced minds, the people who write
these scripts and the executive directors and the Hollywood producers and NBC
and CBS and CNN, all own some responsibility. They have to own some
responsibility for what is happening to children.

H: I do not think many of them are aware of the linkage there.

G: I think that they are beginning to be, and I am hoping that we will see some
different programming in the near future. They took care of the smoking issue.
If I see a person on television smoking, I know it is an old flick [laughter].

H: That is right. It took a long time, though, to get that off.

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G: Yes. But in the most glamorous settings, when the big decision is being made,
there are these beautiful brandy and wine glasses and this very elaborate
opulence, if you will, and that is where the negotiation occurs. So that is alcohol
and sex. That is the other thing that we find. I am in the process of writing a
grant that I hope to submit to NIH soon, in the next few months anyway, [to
study] the direct linkage between alcohol use and drug use and sexual activity
among adolescents, also among adults. In what happens with adolescence, and
adults too, is that they partake of the alcohol or drugs first, and then the
inhibitions are such that it is harder to say no. Whatever cognitive abilities they
may have had, they no longer know how to negotiate out of a dangerous
situation. So that is linked very closely together. If you look at TV, it is too.

H: Certainly TV [is full of sex and drugs], and kids sit [and watch hours of TV every
day].

G: Just casually turning it on, except for the "McNeil-Lehrer Report" and a few
others like that and Bernard Shaw and Larry King. I mean, that is what you get.
[laughter]

H: But they are exposed. They are given the wrong message, and if the family is
not able to cope in the beginning, then I can see where kids are going to end up.

G: Now, I have not seen "Murphy Brown," so I do not know whether alcohol was
involved in that situation with Murphy Brown. I have not looked at that [laughter].

H: That is a whole other ball game.

G: Yes, glamorizing the single parent kind of thing. But I have not looked at that, so
I cannot comment on that. I just know in the course of the day with the common,
ordinary, tired citizens such as myself, when I turn on TV and am not looking at
the news, I can almost see that anything might happen. Then you can call in
these numbers.
H: That is something new, and scary, the 900 numbers.

G: Yes. You can call in and get all of this erotic talk. It is just everything in our
society is commercialized.

H: Like you say, we are on a slippery slope. I honestly think that is such an apt
description.

G: Unless we can clean it up fast.

H: You said earlier that you were President of what house?

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G: Arnett House. That is in Ocala.

H: Tell me something about that.

G: Well, it is a shelter. I have a little brochure that I could probably mail to you. It
started maybe in the early 1980s. A very prominent citizen in Ocala had a son
who got involved in alcohol and drugs, and he was sent to a psychiatric hospital.
This is a very wealthy family, and he was sent off to the best psychiatric
hospital. He came back home and did well for a while. [Then he] ran away from
home and went to Miami and took an overdose of drugs cocaine, heroine, or
something and died, and the parents were just devastated. The nurse and a
retired colonel in Ocala who knew this family suggested as part of the healing
process that instead of [sending] flowers and cards that people try to open a
house for children who run away so they could have some place to go. The
house has had about four homes now, but now we are in a permanent building
with twenty beds. It started with one bed and volunteers, and then it went to two
beds and then four beds and six beds, three for girls and three for boys. Now we
have ten for boys and ten for girls, and it is usually full. It is HRS supported,
almost 80 percent HRS supported, and the rest [of the support comes from]
United Way and individual funds.

H: Oh, wonderful.

G: The Interface here is similar to the Arnett house in Ocala. There is a Florida
Youth and Family Network that coordinates all of the shelter activities in Florida,
and there is a national organization and an international organization. So
internationally people are recognizing that children are running away all over the
world. They are running away from home into terrible danger.

H: I am not sure that I was very much aware that it was an international problem.

G: Yes. Well, in Brazil, for example, where the economy is such and I have to
relate this to the economy their children are seen as burdens, and there are
death squads in Brazil to kill children.

H: I have read that.

G: I have been in Brazil and have seen children sleeping on the streets just right out
of the hotel where I was living, and people just stepped over them. But then I
say we do the same thing when I go to Washington. I was living at the
Watergate maybe about three years ago I had a seminar on bioethics at
Georgetown and when I went to get into my taxi in front of the Watergate hotel,
there were homeless people sleeping on the grate. I had been in a warm, nice

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place all night.

H: And they were just trying to keep warm.

G: Yes. Then I went to Georgetown, which is also a very nice place, but that was
not a part of the conversation.

H: Do you think it is a lack of concern as much as [the overwhelming aspect of the
situation]? I mean, it is such a big problem. What in the world can we do?

G: I think we have no choice but to address it. I think in the last twelve to fifteen
years we as Americans have been so narcissistic. We focused on ourselves for
a very long time. The 1980s was a very peculiar time. We were into
entrepreneurship, which is fine, but we were capitalists par excellence for those
who had. I am back to the role of government, and I think a basic role of
government is to provide mechanisms for people to better themselves. I think
we have to do that with the public and private sector, but I think when people
cannot provide for themselves it becomes the government's responsibility. We
have just acted as if the homeless do not exist, and that has been okay. I think
that is part of the problem that bothers me, that it has been okay for us to act as
if the homeless did not exist.

H: Well, certainly we are seeing that right here, with Saint Francis House and the
difficulty they have had with being accepted and staying open. It is almost as if
people are saying, "If you were not here there would not be any homeless
problem," which is kind of an interesting reaction [laughter].

G: It is denial. People do not want to have to deal with it. We do not want to
confront our failures. We think they will go away automatically, and that is
absurd.

H: Or that they are not there.

G: Or that they are not there. But once we confront them, that means we legitimize
that we know they exist.

H: It is such a tremendous problem it is hard to know where to put your foot down
and say, "Well, this is what we do to start."

G: Exactly.

H: With your twenty children, you keep full all the time in the home.

G: Sure.

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H: What do you do about meals and counseling? Do you have counseling
programs there?

G: We have full-time counselors, and now HRS has mandated that a different kind
of program be instituted. They are trying to do the prevention.

H: That seems important.

G: We still have to keep four beds for runaways, but now children can go there if
they threaten to run away or are beginning to be management problems at
home.

H: That is good.

G: What has to happen is that the children or the child comes to the shelter, but the
parents must come for X number of counseling [sessions].

H: How long have you been doing that?

G: About two years.

H: How is it working?

G: Good.

H: It is?

G: It is good.

H: It is making a difference?

G: Well, we think so, but we do not have [proof]. If you asked me to show you
some definitive data, I could not show you. I could share with you anecdotal
kinds of data. One of the things that I am requesting is that we hire an evaluator
for our program ..

H: I would think that would be very hopeful.

G: ... so that we can be able to say definitively, "This is the difference we are
making." If you look at health care see, this is directly related to health care -
we have forty million people in America with no health insurance at all. Now,
what is happening is the children have almost no resources; at least lower
middle class and lower class children and their families have no resources for

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counseling. So at our facility, where we do it on an almost-nothing basis, it is
almost overwhelming. The floodgates have been opened, so the children and
their families can come there for counseling. Of course, Grant Center closed,
and that was for people who could pay.

H: It did? I did not know Grant Center closed.

G: Grant Center has been closed now for about two years, and that is when the
insurance industry began to wane in paying for mental health. What would
happen is that you could use up your insurance resource within twenty-seven
days at a private for-profit or not-for-profit hospital.

H: I am not surprised.

G: You have to have a tremendous turnover to keep putting people in there who can
pay. On the other hand, the private hospitals are extremely expensive, and
mental illness is a chronic illness.

H: And so very expensive.

G: And it has to be treated that way. We are forever going to need group homes
and halfway homes and quarterway homes and one-sixthway homes and day
hospitals and night hospitals. As a society we are just going to have to
understand that if we are going to get people off the streets that is what we are
going to have to have.

H: It makes sense; that is what we will need.

G: I believe that every person, except those who are extremely and profoundly
retarded, can make some contribution on a daily basis.

H: Are there very many profoundly retarded people among the homeless?

G: No. They do not survive as homeless. They do not survive because you have to
have some skills to remain homeless and live.

H: That is right. I guess you would.

G: You have to have a sense of direction, however wayward one thinks it might be.

H: I have a couple of questions about the counseling. First of all, in the preventive
program, when the parents are required to come in for some sessions, what are
their attitudes?

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G: They are relieved to get a respite. The youth can stay there for up to two weeks,
and they are so relieved to get a good night's sleep and not have to yell or get up
through the night to see if Johnny or Susie is home.

H: So the counseling is helping the parents.

G: And the child. The child gets a cooling-off period and interacts with another adult
and other children, where there can be some reality testing that takes place.

H: They can stay for two weeks?

G: Yes, and sometimes beyond that. They are reviewed every week, and they can
stay up to two weeks, sometimes three.

H: Then when their time is up, you know they are not cured, of course.

G: No, no.

H: The problems are not solved.

G: Right.

H: What resources are they referred to after that point?

G: They become in the HRS system, but they go home, and their parents remain
their guardians. But they can continue to get services on an out[-patient basis]
from our family mediation program. It is just like an out-patient program, and that
is run by a social worker and a counselor. The other is that sometimes they are
referred for more intensive counseling if their problem would so warrant that or if
the counselors would so state. Sometimes they come back to Arnett House, and
other times they end up in the court system; it is not a cure.

H: But there is an open door to getting help that way.

G: Yes. Hopefully we began to nip the problem in the bud so we will not have so
many longterm casualties.

H: Yes, that is very refreshing to think that at least the prevention aspect is in effect,
because that is really where it is at. From my point of view, you know where I
would start up.

G: Yes, yes, I know--in the delivery room, Betty [laughter].

H: Right [laughter].

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G: No, [you would start] when you start Lamaze. You would start at that first
prenatal visit, knowing you, Betty.

H: I would start way back there.

G: That is right. Get these healthy babies. That is exactly right.

H: It is really a discouraging problem, because there is so much education of people
to do to bring about enough understanding so that we can develop some
mechanisms for it.

G: Exactly. I think we are beginning as a nation to be just a bit more aware of what
is going on around us. I listen to clips of Janet Reno's conformation hearings [for
attorney general] when I get home at night, and she openly said it was
heartbreaking to see some of these youngsters come. She recognized that the
system has to be reformed in order to address the problems.

H: She is in a good place to be doing it.

G: She has had tremendous experiences. To use Ross Perot's metaphor, she has
had grease under her nails for a long time. She knows what is going on. So I
think that is the other reason I can acclimate to her soul, because she has been
in the trenches for a long time. That is also refreshing. I think she is a real
humanitarian and also very practical and knows what the realities of the world
are. The system does not work anymore.

H: It really does not.

G: You cannot lock these kids up and say, "There is no law here. You have to wait
for three months." You cannot do that anymore. It bothers me that Lawton
Chiles is building 21,000 more prison beds, but I do not hear very much about
scholarships for kids to go to school. His budget calls for 21,000 more prison
beds. That is fine. I think our streets need to be safe. But there is another part
to this. People have to have skills and some kind of self-esteem.

H: In order to not end up needing one of those beds.

G: That is right.

H: That is the prevention part of that. That has always been sort of the last thing to
be dragged into the picture.

G: That is right. So we have some major restructuring to do. We are talking about

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health care reform, but I think all of our major institutions need to be reformed, to
include the lobbyists, by the way. I might put them at the top of the list. They
have been too effective in the past.

H: They have gotten their way.

G: They have been too effective, to the demise of all of us.

H: Well, let us hope that there will be some changes with this new administration.

G: Let's hope so.

H: Open the doorways for us to take care of some of these problems.

G: Yes.

H: But then it is international. You could almost deal with it better if you just thought
it was one country, but it is all around the world and worse in some places. At
least we are not out shooting kids down like in Brazil.

G: That is right, but we have a psychological disdain that kills them.

H: Yes.

G: The bottom line is that the same thing happens, but it just takes longer.
H: It may not be as kind as what they do there. What an awful thought, an awful
thing to say!

G: They at least publicly admit that they do not want these children who are
liabilities around. We have not yet come to that, but that is the way we act.
When we refuse to provide health care for pregnant women, what is that saying?
When we refuse provide an opportunity for a decent education for kids, or when
we refuse to make the school system safe so kids can learn or the streets safe
for every citizen in America, [it is not a good indication of the direction in which
we are headed]. I think the streets need to be safe. It is saying it in many ways.
I have come to the conclusion that people dialogue about what our role should
be in [this] post-Cold War era, and I have decided that our role should revolve
around getting our own country in order. That is probably the best thing we can
do for the world is to get our own country in order.

H: Yes. I see some effort being made in that direction right now, which is very
good, very refreshing.

G: Yes. Exactly.

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H: Well Faye, this has been wonderful.

G: It was wonderful to talk to you, Betty.

H: You taught me a lot today.

G: Well, thank you for asking me. We are still missing you. I remember your office
was down the hall from me, and I could always count on a lucid, kind professor
who was willing to share wisdom and knowledge with others. We miss you!